Randomized controlled trial of vacuum therapy for intermittent claudication

OBJECTIVE: The "gold standard" treatment of intermittent claudication (IC) is supervised exercise therapy (SET). Intermittent vacuum therapy (IVT) has recently been promoted as an additional treatment of IC. During IVT, negative pressure and atmospheric pressure are alternatingly applied to the lower extremities, possibly resulting in improved circulation. The aim of this study was to determine a potential additional effect of IVT in IC patients undergoing a standardized SET program. METHODS: IC patients were recruited from three Dutch general hospitals between December 2015 and July 2017. They received a standardized SET program but were also randomly assigned to an intervention group receiving an IVT treatment (-50 mBar negative pressure) or a control group receiving a sham treatment (-5 mBar negative pressure). IVT was provided in a dedicated clinic during 12 sessions of 30 minutes during a 6-week period. The primary outcome measure was a change in maximal treadmill walking distance. Secondary outcome measures were a change in functional treadmill walking distance, 6-minute walk test, ambulatory ability, and quality of life. RESULTS: A total of 78 patients were randomized, of whom 70 were available for intention-to-treat analysis (control, n = 34; intervention, n = 36). At 6 and 12 weeks, increases in walking distance were of equal magnitude. Median (interquartile range) change in maximal treadmill walking distance during 12 weeks was +335 (205-756) meters in control patients and +250 (77-466) meters in intervention patients (P = .109), whereas functional treadmill walking distance increased +230 (135-480) meters and +188 (83-389) meters (P = .233), respectively. Mean ± standard deviation change in the 6-minute walk test was +36 ± 48 meters and +55 ± 63 meters (P = .823), respectively. Ambulatory ability and quality of life improved equally in both groups. CONCLUSIONS: IVT does not confer any additional beneficial effects in IC patients undergoing a standardized SET program

Salinity tolerances of two Australian freshwater turtles, Chelodina expansa and Emydura macquarii (Testudinata: Chelidae)

Freshwater biota experience physiological challenges in regions affected by salinization, but often the effects on particular species are poorly understood. Freshwater turtles are of particular concern as they appear to have limited ability to cope with environmental conditions that are hyperosmotic to their body fluids. Here, we determined the physiological responses of two Australian freshwater chelid turtles, Emydura macquarii and Chelodina expansa, exposed to freshwater (0‰) and brackish water (15‰, representing a hyperosmotic environment). Brackish water is common in the Murray–Darling River Basin within the natural range of these species in Australia during periods of drought, yet it is unknown how well these species tolerate saline conditions. We hypothesized that these turtles would be unable to maintain homeostasis in the 15‰ water treatment and would suffer osmotic loss of water, increased ionic concentrations and a decrease in body mass. Results revealed that these turtles had elevated plasma concentrations of sodium, chloride, urea and uric acid in the plasma. Plasma ionic concentrations increased proportionally more in E. macquarii than in C. expansa. Individuals of both species reduced feeding in 15‰ water, indicating that behaviour may provide an additional means for freshwater turtles to limit ion/solute influx when in hyperosmotic environments. This osmoregulatory behaviour may allow for persistence of turtles in regions affected by salinization; however, growth rates and body condition may be affected in the long term. Although we demonstrate that these turtles have mechanisms to survive temporarily in saline waters, it is likely that sustained salinization of waterways will exceed their short- to medium-term capacity to survive increased salt levels, making salinization a potentially key threatening process for these freshwater reptiles

Alveolar Rhabdomyosarcoma with Regional Nodal Involvement: Results of a Combined Analysis from Two Cooperative Groups

BACKGROUND: Treatment of children and adolescents with alveolar rhabdomyosarcoma (ARMS) and regional nodal involvement (N1) have been approached differently by North American and European cooperative groups. In order to define the better therapeutic strategy, we analyzed two studies conducted between 2005 and 2016 by the European paediatric Soft tissue sarcoma Study Group (EpSSG) and Children’s Oncology Group (COG). METHODS: We retrospectively identified patients with ARMS-N1 enrolled in either EpSSG RMS2005 or in COG ARST0531. Chemotherapy in RMS2005 comprised IVADo (ifosfamide, vincristine, dactinomycin, doxorubicin), IVA and maintenance (vinorelbine, cyclophosphamide); in ARST0531 it consisted on either VAC (vincristine, dactinomycin, cyclophosphamide) or VAC alternating with VI (vincristine, irinotecan). Local treatment was similar in both protocols. RESULTS: The analysis of the clinical characteristics of 239 patients showed some differences between study groups: in RMS2005, advanced IRS Group and large tumors predominated. There were no differences in outcomes between the two groups: 5-year event-free survival (EFS), 49%(95%CI=39–59) and 44%(95%CI=30–58), and overall survival (OS), 51%(95%CI=41–61) and 53.6%(95%CI=40–68), in RMS2005 and ARST0531, respectively. In RMS2005, EFS of patients with FOXO1-positive tumors was significantly inferior to those FOXO1-negative (49.3% vs 73%, p=0.034). In contrast, in ARST0531, EFS of patients with FOXO1-positive tumors was 45% compared with 43.8% for those FOXO1-negative. CONCLUSIONS: The outcome of patients with ARMS N1 was similar in both protocols. However, patients with FOXO1 fusion-negative tumors enrolled in RMS2005 showed a significantly better outcome, suggesting that different strategies of chemotherapy may have an impact in the outcome of this subgroup of patients

Ultrastructure of the spermatozoon of Leiopelma hochstetteri (Amphibia, Anura, Leiopelmatidae)

Scheltinga, David M., Jamieson, Barrie G. M., Eggers, Karen E., Green, David M. (2001): Ultrastructure of the spermatozoon of Leiopelma hochstetteri (Amphibia, Anura, Leiopelmatidae). Zoosystema 23 (1): 157-171, DOI: http://doi.org/10.5281/zenodo.540074

Spermatozoal ultrastructure in the spiny lobster Jasus novaehollandiae Holthuis, 1963 (Palinuridae, Palinura, Decapoda)

The spermatozoal ultrastructure of the spiny lobster Jasus novaehollandiae is most similar to that in other investigated palinurans and, in particular, to the spermatozoa of Panulirus species. Shared characters include the globular nucleus penetrated by the bases of three or more microtubular arms; an anteriorly situated cytoplasmic zone with mitochondria and conspicuous lamellar bodies; a complex, four-zoned acrosomal vesicle (however, lacking the crystalline region present in Panulirus) with a homogeneous region; a scroll region; a flocculent region; and a region of periacrosomal material that forms finger-like involutions into the flocculent region. The related scyllarid slipper lobsters (Scyllarus and Thenus) possess spermatozoa with acrosome morphology similar to that of Jasus, but the sperm is generally more flattened, numerous radiating acrosome fins are present, and the microtubular arms (in Scyllarus) are cytoplasmic in origin and not nuclear. Sperm morphology provides preliminary evidence in support of the hypothesis of two independent lines of evolution in the Palinuridae but investigation into additional taxa within this group is required. J. Morphol. 236:117-126, 1998. © 1998 Wiley-Liss, Inc

An ultrastructural study of spermatozoa of the Majidae with particular reference to the aberrant spermatozoon of Macropodia longirostris (Crustacea, Decapoda, brachyura)

A total of 17 species, in 14 genera of majids have been examined for sperm ultrastructure. The present account describes the sperm of six of these species, in two subfamilies: Pisinae-Sphenocarcinus orbiculatus and Sphenocarcinus stuckiae and Inachinae-Cyrtomaia furici, Grypacheus hyalinus, Platymaia rebierei and Macropodia longirostris. M. longirostris has the only eubrachyuran sperm in which the acrosome is known to depart radically from a subspheroidal form. The acrosome is semilunar in shape and is bordered by a very thin layer of cytoplasm and an unusually uniform, narrow band of chromatin. The apical surface of the acrosome is almost flat, though slightly concave, whereas the posterior surface forms a hemisphere, and is almost completely occupied by the thin, centrally perforate, electron dense operculum. The bulk of the acrosome consists of a homogeneous, moderately electron dense outer acrosome zone. This surrounds a small inner acrosome zone internal to which is an ellipsoidal, pale perforatorium capped by a central acrosome zone. Majid sperm are distinguished by a flattened and/or centrally depressed operculum; a further characteristic is that the pointed perforatorium is relatively short and frequently does not reach the operculum. They vary inter alia with regard to presence or absence of a posterior median process and, apparently, of centrioles and of microtubules in the nuclear arms, and in the number of these arms. Perforation of the operculum, seen in the Pisinae, is not constant in the Inachinae. Spermatozoal ultrastructure offers no certain support for a close relationship of majids with parthenopids or hymenosomatids

Comparative ultrastructure of the spermatozoa of the Majoidea (Crustacea, Decapoda, Brachyura) with new data on six species in five genera

Comparative ultrastructure of majoid spermatozoa belonging to 23 species, in 19 genera and five families, is considered, with new data on Schizophrys aspera; S. rufescens (Majidae, Majinae); Camposcia retusa (Inachidae); Pyromaia tuberculata (Inachoididae); and Huenia heraldica and Menaethius monoceros (Epialtidae, Epialtinae). The oregoniid Chionoecetes opilio, and inachids Cyrtomaia furici, Platymaia rebierei, Macropodia longirostris and Inachus phalangium, possibly with Camposcia retusa, but not Podochela riisei, appear to form a group. Within the inachids, Macropodia and Inachus are especially close. A domed central acrosome zone, seen in most inachid sperm, in majines (both Schizophrys species), in pisines (Oxypleurodon orbiculatus and O. stuckiae) and epialtines (Huenia heraldica and Menaethius monoceros), appears to be an autapomorphy of these majoids. A peripheral acrosome zone is seen in the inachid Grypacheus hyalinus, two inachoidids (P. tuberculata and Stenorhynchus seticornis) and the majid Maja squinado. Pyromaia tuberculata differs from other inachoidids in having a slightly dome-shaped operculum. The mithracine Macrocoeloma trispinosum (Majidae) sperm more closely resembles Inachoididae, than Inachidae. Spermatologically, the family Majidae and the subfamily Majinae are not homogeneous. Spermatozoal ultrastructure does not support a majoid-hymenosomatid relationship and is equivocal with regard to the placement of Cryptochiridae in either the Thoracotremata or Heterotremata, the prominent operculum strongly differentiates cryptochirids from Majoidea. Acta Zoologic